amfAR, The Foundation for AIDS Research

Managing a Critical Transition

TREAT Asia Conducts Training on Transitioning From Pediatric to Adult HIV Care

Adolescence is a difficult time for children who have grown up with HIV. In addition to the emotional and physical changes that come with being a teenager, at some point between the ages of 15 and 18 most young people in Asia receiving their HIV care at a pediatric clinic will have to transfer to an adult clinic.

As part of its ongoing efforts to improve the process of transition, TREAT Asia, together with the Cambodian National Center for HIV/AIDS, Dermatology and STDs (NCHADS), conducted a training in January in Phnom Penh for clinicians who work with HIV-positive children and adolescents to help them better prepare for the move to adult HIV care.

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Left to right: Dr. Suvaporn Anugulruengkitt, Lecturer, Chulalongkorn Hospital, Thailand; Dr. Annette Sohn, Director, TREAT Asia; Dr. Wipaporn Natalie Songtaweesin, Research Fellow in Pediatric Infectious Diseases, Chulalongkorn Hospital, Thailand

“The health and well-being of young people with HIV/AIDS hinges on uninterrupted and successful transition to adult care,” said Helen McDowell, Director of ViiV Healthcare’s Positive Action for Adolescents, which supports TREAT Asia’s adolescent transition and training activities. “Transitioning to adult care involves confronting the discrimination and intra-/inter-personal complications associated with a communicable and socially stigmatized chronic infection. Without adequate preparation, the transition from pediatric to adult HIV care can be compromised with potentially serious health consequences.”

The recent training focused on clinical challenges in long-term HIV care and treatment, communication and management strategies to improve retention in HIV care, and adolescent HIV transition care models.

Presenters and facilitators were Dr. Ngauv Bora and Mr. Roeun Moeung of NCHADS; Dr. Suvaporn Anugulruengkitt and Dr. Wipaporn Natalie Songtaweesin of Chulalongkorn Hospital, Thailand; Ms. Phok Many of New Hope for Cambodian Children; and Dr. Annette Sohn and Ms. Aoy Boonsuk of TREAT Asia.

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Participants at the training in Cambodia on transitioning from pediatric to adult HIV care

“TREAT Asia’s training was very important, and its user-friendly toolkit may play an important role in our management of this transition,” said Dr. Vohith Khol, Chief of the Research Unit at NCHADS. Dr. Khol was one of the 45 leading pediatricians, adult clinicians, pediatric and adult counselors, and psychologists who attended the training. “Adolescents living with HIV face complex social, economic, and health issues and present some of our most problematic challenges. Although we have guidelines for the transition from pediatric to adult HIV care in Cambodia, they still have gaps and cannot always be applied,” he said. “We learned a lot from the experiences of our colleagues from Chulalongkorn University, and we hope that TREAT Asia will be a key partner in helping us update our transition guidelines.”

The group heard a presentation about the new TREAT Asia Transition Toolkit, which resulted from a collaboration with the staff and youth of the Children and Youth Program of the Thai Red Cross AIDS Research Centre in Bangkok.

“Adolescents living with HIV need adult providers who can offer developmentally appropriate transition interventions that address loss, disclosure, and sexual behavior along with medical needs,” noted Ms. McDowell. “The transition toolkit is an invaluable resource to enable more effective outcomes for young people going through the critical transition phase.”

Similar trainings are planned for adolescent HIV care providers in Indonesia, Malaysia, and Vietnam.